Natural Products

Sage

Salvia officinalis

Efficacy

• Indications with proven efficacy:
  None
• Indications with possible, but poorly documented efficacy - the use of this product cannot be recommended:
  Digestive problems
  Excessive perspiration
  Nose and throat mucous membrane inflammation (topical)
• Also used for these other indications, but with no proof of efficacy:
  Galactorrhea

Security

• Risk of Drug Interactions: Low
• Adverse Effects: Not Frequent

What is it?

Sage is a subshrub cultivated in Europe and America. The applicable part of the plant is the leaf. Sage contains 1% to 2,8% of volatile oil that appears to be responsible for its therapeutic effects. However, this oil is rich in thujone, a potentially toxic compound. Sage is often mixed with other plants to prepare infusions and decoctions.

Warning

In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) or homeopathic medicine number (DIN-HM) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.

Medicinal plants content varies naturally from plant to plant – just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.

For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.

Does it work?

There is no evidence that sage is effective in any indication. However, it is used to treat certain medical conditions where it may be of some benefits:

• Digestive problems, excessive perspiration:
  Steep 1 to 4 g of dried leaves in 150 ml boiling water for 5 to 10 minutes, three times a day; or 160 mg of dry extract (5,5:1) three times a day.
• Nose and throat mucous membrane inflammation:
  Mix 2,5 g of leaves or 2 to 3 drops of essential oil in 100 mL of water or dilute 5 mL of liquid extract in 100 mL of water. Use as a gargle or rinse three times a day.

There is insufficient reliable information to conclude that sage is effective in any other indication.

Is it safe?

• At recommended doses, sage is associated with few adverse effects: dry mouth, local irritation. However, prolonged used or large amounts can induce fatigue, vomiting, dizziness, palpitations, tremors, seizures and kidney damage.
• Sage may interact with anticonvulsants and oral hypoglycaemic agents. Before taking sage, check with your pharmacist to make sure that there are no interactions with your regular medication.

Clinical notes

• Ingesting sage oil can induce seizures and may be toxic to the nervous system because of its high thujone content, a compound found in absinth. Sage oil should never be taken orally.

References

1. Blumethal M et al. The Complete German Commission E monographs, 1998
2. Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2007
3. Passeportsanté.net. Sauge. http://www.passeportsante.net
4. Barnes J. et Al. Herbal Medicines, 2e édition, Pharmaceutical Press, 2002